Noninvasive Plaque Imaging Using Multislice Detector Spiral Computed Tomography

ABSTRACT

Multislice detector spiral computed tomography (MSCT) is a noninvasive modality for visualization and evaluation of atherosclerosis in vivo in different arterial beds. Rapid technical advances led to a significant improvement of the diagnostic accuracy of coronary MSCT angiography. The most popular clinical application with best scientific Medical evidence of MSCT is the noninvasive detection and quantification of coronary calcifications. In particular, the concept of determining coronary artery age by evaluating an individual's biological age, rather than his or her chronological age, is attractive and currently under scientific evaluation. In addition to evaluating contrast-enhanced coronary arteries, different stages of atherosclerosis can be visualized. By comparative studies with intracoronary ultrasound, it could be shown that echogenicity corresponds well with the density measured within atherosclerotic plaques expressed by Hounsfield units using MSCT. Although the method is improving continuously and is still under development, the potential of MSCT to evaluate plaque composition and plaque volumes noninvasively in vivo is promising.

KEYWORDS

Coronary artery disease - plaque imaging - multislice detector spiral computed tomography (MSCT) - calcium score

REFERENCES

• 1 Naghavi M, Libby P, Falk E et al.. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies. Part II.  Circulation. 2003;  108 1772-1778
• 2 Naghavi M, Libby P, Falk E et al.. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies. Part I.  Circulation. 2003;  108 1664-1672
• 3 Naghavi M, Falk E, Hecht H S et al.. From vulnerable plaque to vulnerable patient-Part III: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report.  Am J Cardiol. 2006;  98 2-15
• 4 Beck T, Burgstahler C, Reimann A et al.. Technology insight: possible applications of multislice computed tomography in clinical cardiology.  Nat Clin Pract Cardiovasc Med. 2005;  2 361-368
• 5 Kopp A F, Heuschmid M, Reimann A et al.. Evaluation of cardiac function and myocardial viability with 16- and 64-slice multidetector computed tomography.  Eur Radiol. 2005;  15(suppl 4) D15-D20
• 6 Johnson T R, Nikolaou K, Wintersperger B J et al.. Dual-source CT cardiac imaging: initial experience.  Eur Radiol. 2006;  16 1409-1415
• 7 Kuettner A, Beck T, Drosch T et al.. Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution.  Heart. 2005;  91 938-941
• 8 Mollet N R, Cademartiri F, van Mieghem C A et al.. High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography.  Circulation. 2005;  112 2318-2323
• 9 Ohnesorge B, Flohr T, Fischbach R et al.. Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT.  Eur Radiol. 2002;  12 1532-1540
• 10 Arad Y, Goodman K J, Roth M et al.. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study.  J Am Coll Cardiol. 2005;  46 158-165
• 11 Raggi P, Taylor A, Fayad Z et al.. Atherosclerotic plaque imaging: contemporary role in preventive cardiology.  Arch Intern Med. 2005;  165 2345-2353
• 12 Raggi P. Noninvasive imaging of atherosclerosis among asymptomatic individuals.  Arch Intern Med. 2006;  166 1068-1071
• 13 Vliegenthart R, Oudkerk M, Hofman A et al.. Coronary calcification improves cardiovascular risk prediction in the elderly.  Circulation. 2005;  112 572-577
• 14 Raggi P. Prognostic implications of absolute and relative calcium scores.  Herz. 2001;  26 252-259
• 15 Schisterman E F, Whitcomb B W. Coronary age as a risk factor in the modified Framingham risk score.  BMC Med Imaging. 2004;  4 1
• 16 Shaw L J, Raggi P, Berman D S et al.. Coronary artery calcium as a measure of biologic age.  Atherosclerosis. 2005;  188 112-119
• 17 De Backer G, Ambrosioni E, Borch-Johnsen K et al.. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice.  Eur Heart J. 2003;  24 1601-1610
• 18 Schroeder S, Flohr T, Kopp A F et al.. Accuracy of density measurements within plaques located in artificial coronary arteries by X-ray multislice CT: results of a phantom study.  J Comput Assist Tomogr. 2001;  25 900-906
• 19 Schroeder S, Kopp A F, Baumbach A et al.. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography.  J Am Coll Cardiol. 2001;  37 1430-1435
• 20 Schroeder S, Kuettner A, Kopp A F et al.. Noninvasive evaluation of the prevalence of noncalcified atherosclerotic plaques by multi-slice detector computed tomography: results of a pilot study.  Int J Cardiol. 2003;  92 151-155
• 21 Schroeder S, Kuettner A, Wojak T et al.. Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations.  Heart. 2004;  90 1471-1475
• 22 Schroeder S, Kuettner A, Leitritz M et al.. Reliability of differentiating human coronary plaque morphology using contrast-enhanced multislice spiral computed tomography: a comparison with histology.  J Comput Assist Tomogr. 2004;  28 449-454
• 23 Virmani R, Burke A P, Farb A et al.. Pathology of the vulnerable plaque.  J Am Coll Cardiol. 2006;  47 C13-C18
• 24 Schroeder S, Kuettner A, Wojak T et al.. Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations.  Heart. 2004;  90 1471-1475
• 25 Leber A W, Knez A, Becker A et al.. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound.  J Am Coll Cardiol. 2004;  43 1241-1247
• 26 Achenbach S, Moselewski F, Ropers D et al.. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound.  Circulation. 2004;  109 14-17
• 27 Leber A W, Becker A, Knez A et al.. Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound.  J Am Coll Cardiol. 2006;  47 672-677
• 28 Hausleiter J, Meyer T, Hadamitzky M et al.. Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients with an intermediate risk for significant coronary artery disease.  J Am Coll Cardiol. 2006;  48 312-318
• 29 Budoff M J. Prevalence of soft plaque detection with computed tomography.  J Am Coll Cardiol. 2006;  48 319-321
• 30 Gerber T C, Stratmann B P, Kuzo R S et al.. Effect of acquisition technique on radiation dose and image quality in multidetector row computed tomography coronary angiography with submillimeter collimation.  Invest Radiol. 2005;  40 556-563